Department Introduction

Pulmonary Medicine | Excellence

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Excellence

Bronchial Diagnosis & Treatment Center
Features of the CenterBronchial Diagnosis & Treatment Center

Our center devotes to extensive and intensive development of the capacity of interventional bronchoscopy and cooperates with a lung cancer team to provide holistic care services. There are two types of bronchoscopy: diagnostic bronchoscopy and therapeutic bronchoscopy. The diagnostic bronchoscopy includes endoscopic ultrasonography (EUS), endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and autofluorescence bronchoscopy. The therapeutic bronchoscopy includes endobronchial electrosurgery, airway stent insertion, balloon dilatation, foreign body removal and the bronchoscopy-guided percutaneous dilational tracheostomy which improves the narrowed and blocked airway caused by lesions. In recent years, we have introduced thoracoscopy, cryotherapy and argon plasma coagulation (APC) to strengthen the diagnosis and treatment of respiratory diseases.

Strength of the Center
EUS serves as an alternative to CT-guided aspiration biopsy to observe the lesions around the lungs. EUS also claims a lower complication rate than that of the latter method. EBUS-TBNA exempts some patients from undergoing diagnostic thoracic surgery and mediastinoscopy and reaches a diagnosis rate as high as 90%. The close collaboration with the division of thoracic surgery and the center’s well-rounded capacity in the diagnosis and treatment options of lung cancer have made the center the training institution of bronchoscopy, which is designated by Taiwan Society of Pulmonary and Critical Care Medicine (TSPCCM).
 

Personalized treatment for lung cancer

Over the course of successful development of personal medicine of lung cancer, biological markers and furtherer research are essential foundation for rigorous clinical trials. We closely work with the department of pathology to develop various genetic tests for lung cancer in order to integrate diagnoses and treatments perfectly and improve patients’ prognoses. For instance, the genetic tests on EGFR and ALK for signs of mutation are critical for choosing target medication, immunotherapy and chemotherapy for patients diagnosed with lung cancer.

EGFR-TKI is a targeted therapy. Since the EGFR mutations is of high frequency in non-small cell lung cancer (NSCLC), EGFR-TKI can bind to the ATP-binding site of the EGFR TK domain to block EGFR activation and downstream signaling, thus inhibiting the cancer growth.

According to the research, EGFR-TKI demonstrates higher efficiency in NSCLC patients with EGFR mutation.

The activating mutations of EGFR occur in approximately <10% of NSCLC cases in Caucasian patients and approximately one-third in East Asian patients; therefore, EGFR-TKI demonstrates higher efficiency in East Asian patients than that in Caucasian patients.

Additionally, we collaborate closely with the Division of Thoracic Surgery in order to offer comprehensive services from quality lung cancer surgeries to an array of treatment options. We usually adopt thoracoscopic lobectomy for lung cancer, of which the operative time is shorter than that of traditional thoracotomy. In addition, advantages of the thoracoscopic lobectomy include decreased pain, decreased inflammatory response, less complications, preserved postoperative pulmonary function, shorter duration of chest tube, shorter length of stay, faster recovery, more rapid return to preoperative activity and increased life quality.

 
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